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Leading medical experts in the field of asthma and allergic rhinitis (hay fever) have cast doubt over whether the drug prescribed to Sir Bradley Wiggins ahead of some of the biggest races in his career would actually have aided his performance as many have claimed in recent days.

His testimony is backed up anecdotally by other riders as well as by some randomised controlled trials [RCTs] with amateur athletes.

Wiggins is reported to have taken one injection ahead of his 2012 Tour de France winCredit:
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Dr Brian Lipworth, of the Scottish Centre for Respiratory Research, said, however, that he believed there was “no scientific reason” why a drug like triamcinolone would be performance-enhancing.

“An anabolic steroid like testosterone puts on muscle mass but this is a catabolic steroid which breaks down muscle,” said Lipworth, who sits on the WHO guidelines committee ARIA. “The benefits to David Millar were probably the fact that he was taking EPO and testosterone at the same time as he was using triamcinolone. So the anaobolic effect of the testosterone probably counteracted the triamcinolone."

Ian Pavord, a Professor of Respiratory Medicine at the University of Oxford, said he too doubted injected triamcinolone could help athletic performance as it would “reduce proximal muscle mass”.

Stephen Durham, the Head of Section for Allergy and Clinical Immunology at NHLI, Imperial College and Professor of Allergy and Respiratory Medicine at Royal Brompton Hospital London, said that to the best of his knowledge it would not aid performance but that "it would require a biochemist/clinical pharmacologist to provide a definitive answer that it would not have minimal effects".

Wiggins will race the Abu Dhabi Tour along with his Six Day partner Mark Cavendish, Alberto Contador
Elia Viviani and Olympic road champion Greg van AvermaetCredit:
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All three, however, described injected triamcinolone as a last resort in terms of treatment, with potential side effects including “cataracts, high blood pressure, diabetes, bone-thinning and Achilles tendon ruptures”.

“It would cure his [Wiggins’s] hay fever, no doubt about that,” Lipworth said. “But the side effects are totally unacceptable in my humble opinion. We see patients who get side effects even on the higher potency inhaled corticosteroids like fluticasone, let alone injectables, which is why it’s utterly bonkers to prescribe it.

“Maybe he had tried everything and this was a last resort. But it still seems a bit bizarre to me when there are so many alternatives which are just as effective but with less severe adverse effects.”

The injections were given over five years ago now, but Lipworth said he could not remember the last time he had prescribed triamcinolone for hay fever.

Durham said that it was not part of guideline management for asthma and was "largely outlawed", calling it an inappropriate TUE for asthma in athletes "on grounds of poor benefit/risk ratio, independent of consideration of potential performance enhancement".

Pavord did point out that the perception of symptoms in patients was very context-specific and said he could see a scenario whereby it was granted as a TUE.

"Mild asthma and hay fever may be intolerable if one aspires to win the Tour," he said. "If it can be used in clinical practice and there is no well-established performance enhancing effect then I don't see a problem. I would want to know if the presence of allergy was well documented (i.e. positive skin test or blood tests showing grass pollen allergy)."

Wiggins, meanwhile, appears poised to prolong his road career nine days after declaring that was “certainly it for the road” after the final stage of the Tour of Britain.